WQCS00270_5-Day Report for 202201598_20221020

Oct. 20, 2022 1:35PM
No.0877 P. 2
Iblvlslon of Wamr Redourcm
NC Dept oeEnvironmentai Quality
State of North Carolina
Department of Environment and Natural Resources
nivision of Water Resources
OCT 2 0 2022
on System Sanitary Sewer Overflow Reporting Form
Raleigh Regionaftee Porn CS-SSO
PART I:
This form shall be submitted to the appropriate DWR Regional Office wwI I In five business days of the first knowledge of the
sanitary sewer overflow (SSO).
Permit Number. WQCS00270 (WQCSf1 if active, otherwise use WQCSD#)
Facility: Town Of Smithfield Incident M 201400607 Owner. Town Of Smithfield
Region- Raleigh Clty: Smithfield County. Johnston
Source of SSO (check applicable): ® Sanitary Sewer ❑ Pump Station / Lift Station
SPECIFIC location of the SSO (be consistent in description from past reports or documentation - i.e. Pump
Station 6, Manhole at westall & Bragg Street, etc.): Between MH 66 and MH 77 on the outfall.
Manhole #: 66/77
Latitude (degrees/minute/second): Longitude (degrees/minute/second),
Incidenl Started Dt: 10/19/2022 Time: 9:30arm Incident End Dt• 10/19/2022 Time: 2:30pnn
(mm-dd-yyyy) (hh:mm) AWPM (mm-dd-yyyy) (hh:mm) AWPM
Estimated volume of the SSO: 600 gallons estimated Duration (round to nearest hour): 5 hour(s)
Describe how the volume was determined: Visual estimation over the period found and perion contained
Weather conditions during the SSO event: Sunny, mild
Did the SSO reach surface waters? tA Yes ❑ No ❑ unknown
Volume reaching surface waters: 600 gallons Surface water name: Swift Creek
Did the SSO result In a fish kill? ❑ Yes ❑ No M unknown
If Yes, what is the estimated number of fish killed?
SPECIFIC cause(s) of the SSO-
®Severe Natural Conditions ❑ Grease
❑Pump Station Equipment Failure ❑ Power Outage
®Other (Please explain in Part 11)
❑Roots ❑Inflow & Infiltration
[]Vandalism ❑ Debris in line OPipe Failure (Break)
24-haur verbal notification (name of person contacted), Stephanie Goss
®DWR ❑Emergency Management Date (mm-dd-yyy). 10/1912022 Time. (hh:mm AMIPM): 3,37pm
Per G S. 143-215.1 C(b), the owner or operator of any wastewater collection system shall:
In the event of a discharge of ixo gallons or more of untreated wastewater to the surface waters of the Slate. Issue
a press release to all print and electronic news media that provide general coverage In the county where the
discharge occurred setting out the details of the discharge. The press release shall be issued within 24 hours after
the owner or operator has determined that the discharge has reached surface waters of the State.
In the event of a discharge of 15,000 gallons or more of untreated wastewater to the surface waters of the State,
publish a notice of the discharge In a newspaper having general circulation in the county In which the discharge
occurs and in each county downstream from the point of discharge that is significantly affected by the discharge. The
Regional Office shall determine which counties are significantly affected by the discharge and shall approve the form
and content of the notice and the newspapers in which the wince is published.
WHETHER OF NOT PART If IS COMPLETED A SIGNATURE IS REQUIRED SEE PAGE 13
Form CS-SSO page l

Oct, 20. 2022 1:36PM
No, 0877 P. 3
In order to submit a claim for justification of an $SO, you must use Part II of form CS-SSO with additional documentation as
necessary. DWR staff will review the juslificalion claim and determine if enforcement action is appropriate.
PART II:
ANSWER THE FOLLOWING QUESTIONS FOR EACH RELATED CAUSE CHECKED IN PART I OF THIS FORM AND
INCLUDE THE APPROPRIATE DOCUMENTATION AS REQUIRED OR DESIRED
COMPLETE ONLY THOSE SECTONS PERTAINING TOT E CAUSE OF THE SSO AS CHECKED IN PART I
(In the check boxes below, NA = Not Applicable and NE _ Not Evaluated)
A HARDCOPY OF THIS FORM SHOULD BE SUBMITTED TO THE APPROPRIATE DWR REGIONAL OFFICE UNLESS
IS HAS BEEN SUBMITTED ELECTRONICALLY THROUGH THE ONLINE REPORTING SYSTEM
Corm CS-SSO Page 2

Oc t. 20. 7022 t : 36PM No, 0877 F. 4
severe Natural Conditions hurricane tornado etc.
Describe the "severe natural condition" in detail: Flooding rain
How much advance warning did you have and what actions were taken in preparation for the event? None
Comments- This aera Is a washout caused by multible rain storms. The location was discovered in April 2022. At
this time we asked the DOT to repair the culvert. This has not been completed, On 10/19/2022 we discovered
that the culvert had washed out and caused the sewer line to be exposed and damaged.
Form CS-SSO Pogo 3

Oct.20.2022 1:36PM No.0877 F_ 5
Other [Pictures and police report. as applicable, must be available upon request.)
Describe:
Were adequate equipment and resources available to fix the problem? ® Yes ❑ No ❑NA ❑ NE
If Yes, explain: The town has a full line of equipment to make the repairs and clean up spill.
If the problem could not be immediately repaired, what actions ® Yes ❑ No ❑NA 0 NE
were taken to lessen the impact of the SSO?
Comments. Contractor was called into make the repairs. Contractor placed a sewer ball in the upstream manhole and
began a pump around while repairs were being made.
Form CS-SSO Page I l

Oct. 20. 2022 1:36PM
No.0877 '. 6
Pipe Failure (Break
Pipe size (inches) Big
What Is the pipe material VCP
What is the approximate age of the line/ pipe (years old)
Is this a gravity line?
Is this a Force main line?
Is the line a "High Priority' line?
2
® Yes ❑ No
❑NA
[] NE
❑ Yes (@ No
❑NA
❑ NE
❑ Yes ® No
DNA
❑ NE
Last inspection date and findings No documented record of this line being inspected.
If a force main then,
Was the break on the force main vertical? ❑ Yes ❑ No
Was the break on the force main horizontal? Q Yes ❑ No
Was the leak at the joint due to gasket failure ?
Was the leak at the joint due to split bell?
❑ Yes ❑ No
❑ Yes ❑ No
❑NA
❑ NE
DNA
❑ NE
LIMA
❑ NE
❑NA
❑ NE
When was the Iasi inspection or test of the nearest air -release valve to determine if operable?
When was the last maintenance of the air release performed?
If gravity sewer then,
Does the line receive now from a force main immediately upstream ❑ Yes ® No DNA ❑ NE
of the failed section of pipe?
If yes, what measures are taken to control the hydrogen sulfide production?
When was the line last inspected or videoed? ?
If One collapsed, what is the condition of the line up and down stream of the failure? Not collapsed
What type of repair was made? point Repair
If temporary, when is the permanent repair planned? )Line to be replace within the next fiscal year.
Have there been other failures of this line in the past five years? ❑ Yes ® No DNA ❑ NE
If so, then describe
Form CS-SSO Page 12

Oct. 20. 2022 1:36PM
No, 0811 P. 7
stem Visitation
ORC ❑ Yes
Backup ® Yes
Name- Aubrey P Butler
Certification Number. 1002951
Date visited: 10/19/2022
Time visited. 9:30am
How was the SSO remediated (Ile. Stopped and cleaned up)?
Contractor was called in to make emergency pouft repair. Made the repair to the sower main, storm drain pipe, and
backfilled up to grade with soil. Straw and lime were spread through out the affected area.
As a representative for the responsible paft. I certify2gat the information contained in this report Is true and accurate to the
best of my knowledge.
Person submitting claim: Aubrey Pat Butler Date: 10/19/2022
Signature: Title:
a.r
Telephone Number: 919-934-2438
Any additional Information desired to be submitted should be sent to the appropriate Division Regional Office within rive
business days of first knowledge of the SSO with reference to the incident number (the incident number is only generated
when electronic entry or this form is completed, if used).
Form CS-SSO Page 13

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